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Quantitative evaluation of morphological and functional changes in meibomian glands and lipid layer thickness in patients with and without keratoconus

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Abstract

Purpose

To quantitatively evaluate the morphological parameters of meibomian glands (MGs) and lipid layer thickness (LLT) in patients with keratoconus (KC).

Methods

In this prospective, cross-sectional study, 164 eyes of 164 keratoconus patients and 64 eyes of 64 age-matched control subjects were included. An advanced automatic MG analyzer was used to quantitatively measure the morphological and functional parameters of MGs. Morphological and functional parameters of MGs, LLT, and other ocular surface parameters were compared between the control and KC groups.

Results

The mean meibomian gland diameter, length, square, and gland area ratio (GA) were all significantly decreased in the KC group (all P < 0.05), while no significant difference was observed in the gland tortuosity index (TI) and gland signal index (SI) between the KC and control groups (all P > 0.05). There was no significant difference in the number of total and incomplete blinking among patients with different stages of keratoconus (all P > 0.05). The gland diameter, square, and TI were all negatively associated with KC severity (all P < 0.05), while no significant difference was observed among all stages of KC in gland length, GA, and SI (all P > 0.05). Moreover, the LLTs were positively correlated with the gland diameter, square, GA, and TI and negatively correlated with anterior corneal curvature or KC severity (all P < 0.05).

Conclusions

Atrophic morphological changes in the meibomian glands were closely correlated with the severity of keratoconus. Gland diameter may be a sensitive functional morphology metric of meibomian glands in patients with keratoconus.

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Funding

This work was financially supported by grants from the Zhi Xing Shi Jie-Ophthalmic Clinical Research Support Project (Grant No. BFC-KECS-LC-20220930–2) and the Guangzhou Science Technology and Innovation Commission (Grant No. 201803010091).

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Author notes

  1. Xiangtao Hou and Chang Liu contributed equally to this work and are co-first authors.

Authors and Affiliations

  1. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, No.7 Jinsui Road, Tianhe District, Guangzhou, 510060, China

    Xiangtao Hou, Chang Liu, Yiqi Luo, Na Yu, Pei Chen, Jing Zhuang & Keming Yu

  2. Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China

    Xiangtao Hou, Chang Liu, Yiqi Luo, Na Yu, Pei Chen, Jing Zhuang & Keming Yu

  3. Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, 510060, China

    Xiangtao Hou, Chang Liu, Yiqi Luo, Na Yu, Pei Chen, Jing Zhuang & Keming Yu

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  1. Xiangtao Hou
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Contributions

Study concept and design (XTH, CL, YQL, NY, JZ, KMY); data collection (XTH, CL, YQL, NY, PC); analysis and interpretation of data (XTH, CL, PC, KMY); writing the manuscript (XTH, JZ, KMY); critical revision of the manuscript (KMY); supervision (JZ, KMY).

Corresponding authors

Correspondence to Jing Zhuang or Keming Yu.

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All procedures performed in studies involving human participants were under the principles of the tenets of the Declaration of Helsinki and were approved by the Medical Ethical Committee of Zhongshan Ophthalmic Center (No. 2016KYPJ025).

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Informed consent was obtained from all individual participants included in the study after a detailed explanation of the procedure.

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Hou, X., Liu, C., Luo, Y. et al. Quantitative evaluation of morphological and functional changes in meibomian glands and lipid layer thickness in patients with and without keratoconus. Graefes Arch Clin Exp Ophthalmol (2024). https://doi.org/10.1007/s00417-024-06443-8

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